The Bottom Line: About 5 percent of infected people have asymptomatic residua in their lungs, usually nodules or thin-walled cavities. In endemic areas, prior C. immitis infection is frequently diagnosed when a lung nodule is resected because of suspected carcinoma.
Summary: Stevens, D. (n.d.). Coccidioidomycosis. The New England Journal of Medicine., 332(16), 1077-1082
The Bottom Line: C. immitis is endemic to the southwestern United States — principally, California, Arizona, and Texas — and also to Mexico and Central and South America. Cases of coccidioidomycosis may also occur outside endemic areas. The diagnosis is often belated, because the infection is not considered initially. Such cases may occur because of a recent visit to an area where disease is endemic, reactivation of an infection acquired earlier in such an area, or infection by fomites from an area of endemic disease, such as spores on an automobile or on fruit.